With the release of the World Health Organization’s (WHO) first-ever report on refugee and migrant health on July 20, 2022, comes a crucial discussion on the urgent actions that need to be taken to ensure that healthcare is accessible to all. Currently, one out of every eight people worldwide is a migrant or is displaced, and this issue continues to grow as a result of various reasons ranging from war, climate change, disease, and famine to seeking better jobs, education, and better overall quality of life. Refugees and migrants bring many skills and talents wherever they relocate to and do contribute significantly to their host country’s economy as productive members of society, yet their health is not a priority in many of these countries.
Though these populations are affected by the same social determinants of health as everyone else, their displacement and migration also serve as an additional determinant of health that makes them more vulnerable and adds a layer of complexity to understanding their health outcomes. For example, the health of girls and women are at greater risk during the process of migration as they have specific needs in regard to hygiene, childbirth, and security that are difficult to attend to in dire settings. Unaccompanied or separated children are another demographic that need to be discussed as they are at high risk of physical and sexual violence as well as developing mental health issues during the arduous process surrounding migration.
Mental health is a crucial topic in the discussion of migrant and refugee health as these populations are subject to many stressors throughout all stages of migration. In many countries, migrant groups have higher instances of psychosis than the general population. Recent estimates by WHO found that mental disorder prevalence is as high as 22.1% in conflict-affected populations. Mental health care for refugees and migrants must be approached from a holistic mindset that considers all their determinants of health, including their migratory status when providing treatment.
The living and working conditions of refugees and migrants also need to be considered when analyzing their overall health. These groups usually have crowded living arrangements and work in more unsafe conditions than other residents in their host countries. This makes them more vulnerable to communicable diseases and occupational injury. Access to safe and secure housing and inclusion in national health policies and initiatives can significantly improve their health.
Inclusive health systems are necessary for improving refugee and migrant health outcomes. Compared to host populations, refugees and migrants have many additional barriers when accessing and utilizing health care services, such as language and cultural barriers, restrictions based on legal status, and high-cost payments. Need-based services and interventions, which are becoming more common, are also difficult to provide for these populations because of the lack of data.
The health workforce worldwide must be trained in providing culturally sensitive and competent care for refugee and migrant populations. Not only does this directly affect them, but it also benefits host populations in the long run. Training providers to practice inclusively can also play a role in reducing the fear of deportation as a result of accessing health services for these groups.
Leadership and governance play a large role in creating a health system worldwide that can sufficiently support the needs of migrant and refugee populations. They must advocate for and create inclusive policies and programs that make healthcare accessible to them in terms of physical, financial, and social factors.
Ultimately, the action plan provided by the World Health Organization to move forward in advancing refugee and migrant health is as follows:
Develop short- and long-term public health action plans that include refugees and migrants
Strengthen the capacity and increase the sensitivity of health systems to meet the needs of refugees and migrants
Enhance understanding of the health promotion and health needs of refugees and migrants
Actively include refugees and migrants within social protection systems
Strengthen health information systems by including an accountability framework and indicators
Promote global research, strengthen knowledge production and build research capacity in health and migration
“Whatever a person’s motivation, circumstance, origin or migratory status, we must unequivocally reiterate that health is a human right for all, and that universal health coverage must be inclusive of refugees and migrants,” expressed WHO Director General Tedros Adhanom Ghebryesus in response to this critical report.
References
Centers for Disease Control and Prevention. (n.d.). Immigrant, Refugee, and Migrant Health. https://www.cdc.gov/immigrantrefugeehealth/about-irmh.html
Lang, Katharine. (2022, July 29). Displacement and health: ‘The anti-immigrant rhetoric needs to stop.’ Medical News Today. https://www.medicalnewstoday.com/articles/displacement-and-health-the-anti-immigrant-rhetoric-needs-to-stop
United Nations. (2022, July 20). WHO calls for action to provide migrant and refugee healthcare. UN News. https://news.un.org/en/story/2022/07/1122872
World Health Organization. (2022, July 20). World report on the health of refugees and migrants: summary. https://www.who.int/publications/i/item/9789240054486